NeuroTalk Support Groups - Please help post laminectomy L4/L5 Jun 2011 now more issues.

Quote:

Originally Posted by sdchic1 (Post 950218)

Hi I had an emergency laminectomy June 2011 and now I am having more issues. I believe my Dr forgets who I am in between visits and tells me something different every time. This time he said he could not figure out why I am having so much pain over a small bulge. Can you please help me interpret my last MRI (after my laminectomy) that was done in Aug 2012. I believe this is more than a small bulge and he has maybe mixed me up with another patient? Am I being a wimp or could these thing be causing my back pain? He has scheduled me a nerve test for feb 1. Also do you know what high intensity zone means? Thank you so much in advance for any insight.
Tll-Tl2,T12-LI andLl-L2 Level: No signihcant disc bulge is seen. The spinal canal and nerve root
foramen appear widely patent.
L2-L3 Level:5 mm posterior disc protrusion with a high-intensity zone. This does not narrow the spinal
canal or nerve root foramen.
L3-L4 Level: 3 mm posterior disc protrusion with a high-intensity zone. This does not narrow the spinal
canal or nerye root foramen.
L4-L5 Level: Postsurgical changes consisting of a right L4 laminectomy. There is enhancing scar tissue at
the laminectomy site and around the right L5 nerve root in the right lateral recess. There is a 4 mm right
paracentral enhancing disc extrusion which contacts the right L5 nerve root in the right lateral and displaces
it towards the facet joint. There is no signihcant stenosis of the spinal canal. There is mild narrowing of the
nerve root foramen.
L5-Sl Level: No significant disc bulge is seen. The spinal canal and nerve root foramen appear widely
patent.
There is no paraspinous mass or intradural mass. The conus medullaris ends at the level of T12-L1 and appears unremarkable.
Impression:
I . Postsurgical changes at the L4-L5 level consisting of a right L4 laminectomy. There appears to be a
residual recurrent right paracentral disc extrusion which results in mild to moderate stenosis of the right
lateral recess, displaiing the right L5 nerve root against the facet joint. The right L5 nerve root may be
compromised to some degree and clinical correlation regarding right L5 radiculopathy is recommended.
2. Posterior disc protrusions at the L2-L3 andl3-L4 levels without significant spinal stenosis.
Sorry for any mispelling/typos adobe reader did not pull all of the information over correctly for some reason!

Dear sdchic, I think we meet again, hi im sorry this is happening to you. To be short ive had 4 lum lams & pain for 30 years, severe, chronic on fentanyl patch pain. Ok, the EMG will most likely show L5 nerve root irritation because my leg wouldnt work & hurt so much i had to go to my parents! Married with little kids! Either the worst pain in leg to date or on a normal EMG check the result was nerve root irritation. The main reason to do surgery is when there is compression on the thecal sac or spinal canal same thing or there is nerve compression as the nerve exits to go out of the spinal column or the neural foramen.
Your radiologist says that these are not a problem on every level but he specifically adds that the L5 nerve root is being held against the facet joint or bone by scar tissue. So, you had part of this disc removed but the nerve now has a blob of disc material on it & its trapped by scar tissue against bone. This needs to be resolved by surgery where your neurosurgeon takes the disc material out, lasers the scar tissue & untraps the nerve root by shaving down the facet joint or hopefully b/c of possible future stability issues can just move the nerve away from the bony facet joint.
However, no surgeon will want to go back in for one year & may try epidural steroid injections, PT & anything else to get the bulging, really extruded disc
to go back off the nerve. My son had a herniated disc & 1 ESI made it completely resolve. So, we pray & hope that this happens! Oh my sympathies & empathies to you sweetheart, just recovering & this pain! After spine surgery all has to settle, nerves, ligaments, tendons, muscles even discs have to redistribute the weight & carry the load that that level omce did. A disc is like a tough sac containing semisolid gel center & if the surgeon cuts the herniated part off it makes sense to me that some of that "center" could leak out very easily. God bless you!